1/n In London, the Great Stink happened. The entire sewer system, such as it was, emptied directly without treatment into the open sewer that was the river Thames. In 1858, for 2 months, the odor became so unbearable that everyone who could remotely afford it fled central London. 
2/n Just before the Great Stink, cholera — then a very *new* disease for 99% of the world — also happened in 1854 in London. And so did John Snow (as in the famous John Snow Memorandum johnsnowmemo.com/john-snow-memo…), who just removed a pump handle, & thereby slashed cholera right down.
3/n *Amazingly*, sense happened. Everyone said, we must build better sewers, maybe even better drinking water. And Joseph Bazalgette happened, & got the job of building a new sewer system. Astonishingly, he said "Bugger small limits", & built a system for >10x the then population
4/ Everything was **hunky-dory** for 25 years after completion of the new London sewer system. Not only did cholera diminish a lot, but also the age-old typhus & typhoid epidemics. The Americans looked at this & said, "We can't let the lousy Brits out-TECH us", so they copied it
5/ Everything was truly hunky-dory. Now dying horribly of cholera or typhoid became much rarer. Now no big stink in big cities.
And then: first real #polio epidemic in the US, Vermont, 1894. Then, in NYC *alone*, 9,000 cases of polio in 1916. And it kept coming back — in waves.
And then: first real #polio epidemic in the US, Vermont, 1894. Then, in NYC *alone*, 9,000 cases of polio in 1916. And it kept coming back — in waves.
6/ Neither isolation nor quarantine stopped the "new" bug of epidemic polio. People started getting, naturally, *worried* about polio. Except, as I said before, polio is an age-old disease, which had previously been *endemic*, not epidemic. What gives?
https://twitter.com/Gurdur/status/1474002782034317322
7/ Polio epidemics became bad; in one in Denmark, in 1952, Bjørn Aage Ibsen invented the modern Intensive Care Unit (ICU, Intensivstation), for which we can all be very grateful today! But he invented it specifically for polio patients — & managed to lower deaths from 90% to 25%
8/ He accomplished slashing death rates from 90% to 25% through the age-old medical/academic wheeze of getting your students to do the grunt work. He enlisted them to manually pump O2 + air into patients' lungs, around the clock.
But hey. What works, works
But hey. What works, works
https://twitter.com/Gurdur/status/1474383224814157827
9/ Now this whole thread followed on from my last one, linked below. And the whole point is: polio likes water, but only infects humans, & can't live all that long alone. Get it as an infant, 6 months to 5 years, you've a good 99.x% chance you'll be fine
https://twitter.com/Gurdur/status/1474358399102038024
@threadreaderapp unroll, thanks. cc. @BernieOCoimin, it's threadreaderapp you want, not threadreader. In a minute, Threadreaderapp will reply to this with the thread.
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